BACKGROUND: Globus sensations, hoarseness and chronic cough are suggested to be atypical manifestations of Gastroesophageal Reflux Disease (GERD). The aim of the study was to investigate whether combined pH-metry and multichannel intraluminal impedance monitoring increases the diagnostic yield. METHODS: 41 patients with atypical GERD symptoms were included in the study. Globus sensation was the dominant symptom in 23 patients (56.1%). The remaining 18 patients (43.9%) complained mainly about hoarseness or chronic cough. All patients were examined by endoscopy, dual-channel pH-metry and impedance monitoring off-therapy with proton pump inhibitors (PPI). Diagnostic yield of the respective method was determined. RESULTS: A total of 26 patients (63.4%) had pathological findings in any method. The highest diagnostic yield was achieved by combined 24-h pH-metry/impedance measurement (61.0%), followed by solely impedance measurement (48.8%), distal pH-metry (29.3%), endoscopy (22.8%) and proximal pH-metry (17.1%). All patients with a positive PPI-test and 25% of patients (5/20) with a negative PPI-test had a pathological result in pH-metry/impedance. CONCLUSION: Multichannel intraluminal impedance monitoring increases the diagnostic yield for objective detection of atypical manifestation of GERD. Combined 24-h pH-metry/impedance measurement has the best diagnostic yield for detection of gastroesophageal reflux and has therefore the potential to represent a new diagnostic gold standard.
BACKGROUND:Globus sensations, hoarseness and chronic cough are suggested to be atypical manifestations of Gastroesophageal Reflux Disease (GERD). The aim of the study was to investigate whether combined pH-metry and multichannel intraluminal impedance monitoring increases the diagnostic yield. METHODS: 41 patients with atypical GERD symptoms were included in the study. Globus sensation was the dominant symptom in 23 patients (56.1%). The remaining 18 patients (43.9%) complained mainly about hoarseness or chronic cough. All patients were examined by endoscopy, dual-channel pH-metry and impedance monitoring off-therapy with proton pump inhibitors (PPI). Diagnostic yield of the respective method was determined. RESULTS: A total of 26 patients (63.4%) had pathological findings in any method. The highest diagnostic yield was achieved by combined 24-h pH-metry/impedance measurement (61.0%), followed by solely impedance measurement (48.8%), distal pH-metry (29.3%), endoscopy (22.8%) and proximal pH-metry (17.1%). All patients with a positive PPI-test and 25% of patients (5/20) with a negative PPI-test had a pathological result in pH-metry/impedance. CONCLUSION: Multichannel intraluminal impedance monitoring increases the diagnostic yield for objective detection of atypical manifestation of GERD. Combined 24-h pH-metry/impedance measurement has the best diagnostic yield for detection of gastroesophageal reflux and has therefore the potential to represent a new diagnostic gold standard.
Authors: Maureen Moore; Cheguevara Afaneh; Daniel Benhuri; Caroline Antonacci; Jonathan Abelson; Rasa Zarnegar Journal: World J Gastrointest Surg Date: 2016-01-27
Authors: Valentin Becker; Romina Drabner; Simone Graf; Christoph Schlag; Simon Nennstiel; Anna Maria Buchberger; Roland M Schmid; Dieter Saur; Monther Bajbouj Journal: World J Gastroenterol Date: 2015-01-21 Impact factor: 5.742